Facilitated communication: Better education through applied ideology

Facilitated communication (FC), or the provision of graduated assistance by staff in the selection of keys on a communication device by people with developmental disabilities, has become a widely used training technique. Although widespread anecdotal accounts of substantial training benefits and unanticipated communicative competence have been reported, controlled experimental and single subject studies have disclosed little evidence of unexpected competencies. We review research on FC, identify cognitive factors that may stimulate acceptance of this as a training method, and suggest procedures to be employed in individual validation situations when critical communications occur.     

Risks and costs of a treatment litigation: Focus on the family

Decision-making in special educational settings is always based on an implicit process of assessing risks, costs, and benefits of proposed alternative program options. We urge decision-makers to make the process explicit. The hidden costs of IEP decisions are discussed in the context of the question of using aversive procedures to treat severe destructive behavior. Some agency decisions result in significant cost transfer to or generation of risks and costs for families. The experiences of one family involved in a due process proceeding with a school system are examined for evidence of burdensome psychological, social and financial consequences.     

Behavior disorder teams: An efficient institutional strategy

Recent trends toward deinstitutionalization have lead to an increased prevalence of behavioral and physical handicaps within institutional populations. At the same time, funding allocations have remained constant or have reduced creating an ever increasing need for the most efficient and cost-effective delivery of services. The present article traces the evolution of a program designed to create in-house panels of experts in an intermediate care facility for nonambulatory, severely and profoundly retarded children. The model is proposed as a means of improving quality of care and staff expertise and reducing the need for outside consultation.     

Risks,choices and behavioral treatment

Recent arguments against the use of intrusive behavioral interventions in the treatment of handicapped people are examined. The anti-aversive position was found to be based on assumptions about the negative impact of aversive procedures, and to consider only a small subset of the variables that should be taken into account when treatment decisions are made. A preliminary application of formal decision-analysis techniques that have been developed in response to other controversial technologies had a number of benefits including: (a) sharpening the distinction between scientific and social criteria; (b) sensitizing decision-makers and scientists to the range of costs, risks, and benefits associated with treatment decisions; and (c) identifying critical areas of research. Decision-analysis techniques were found to be helpful in directing scientists and policy-makers towards more informed decision-making.     

Test-retest reliability of the Revised Children's Manifest Anxiety Scale

Test-retest reliabilities of the Revised Children's Manifest Anxiety Scale over 1- and 5-wk. intervals were examined for two samples of students, 73 boys and 88 girls in regular sixth, seventh and eighth grade classrooms (11 yr. to 14 yr.). For raw scores the test-retest Pearson r was .88 (1-wk.) and .77 (5-wk.), indicating good reliability. For both samples there was a small difference between test (12.2 for 1-wk. sample; 11.4 for 5-wk. sample) and retest (11.2 for 1-wk. sample; 9.8 for 5-wk. sample) mean raw scores. Implications for test use are discussed.     

Development of the Behavioral Evaluation of Disorders of Sleep Scale

We describe the development, preliminary psychometric properties, and cross-validation of the Behavioral Evaluation of Disorders of Sleep (BEDS: Schreck 1997/1998). Parental reports of problem sleep behavior in elementary school aged children 5 years to 12 years were collected for two samples. With the first sample, an exploratory factor analysis of parental responses (N = 307) resulted in reports of five distinct types of sleep problems: Expressive Sleep Disturbances; Sensitivity to the Environment; Disoriented Awakening; Sleep Facilitators; and Apnea/Bruxism. Four of these factors (Expressive Sleep Disturbances; Sensitivity to the Environment; Disoriented Awakening; and Apnea) were confirmed with the new participant sample (N = 1054). These factors of problem sleep behavior were similar to findings in other studies, with the exception of the exclusion of bedtime behavior problems.     

Contingent electric shock (SIBIS) and a conditioned punisher eliminate severe head banging in a preschool child

We report a case in which a Self‐Injurious Behavior Inhibiting System (SIBIS) device and a conditioned punisher were utilized to decrease and maintain suppression of severe head hitting/banging in a preschool child. After an experimental evaluation conducted at the hospital, SIBIS was implemented at home. The originality of this particular SIBIS case study is that programmed and systematic effort at establishing conditioned punishment was included in the intervention. Results indicate that a zero‐level response was rapidly reached, and that the conditioned punisher (i.e. verbal prompt + movement towards the place where SIBIS was kept) was sufficient to maintain treatment effects. Continuous assessment after treatment and formal observation session at 7 months follow‐up revealed that SIBIS could be removed from the natural environment of the child while maintaining a therapeutic effect. These results were interpreted as the effects of the explicit pairing between the delivery of electric stimulations and previously neutral stimuli, which were initially ineffective to elicit any response, or to suppress SIB. Close and extended monitoring during and after treatment failed to reveal the presence of negative side effects associated with SIBIS, whereas a number of positive effects were observed. Copyright © 2004 John Wiley & Sons, Ltd.